Inadequate Disease Control with Current Therapies Among Patients with a History of Moderate-to-Severe Atopic Dermatitis

INTRODUCTION: This study assessed disease control and symptom burden among US adults with moderate-to-severe atopic dermatitis (AD) treated with topical-only or systemics (conventional [corticosteroids/immunosuppressants]/advanced [biologics/JAKi]) ± topicals. METHODS: Data were obtained from the Adelphi Atopic Dermatitis Disease Specific Programme, a cross-sectional real-world survey (August 2022-March 2023). Physicians completed patient record forms, and patients completed quality-of-life and symptom questionnaires. Uncontrolled AD was defined by physician-reported flares, dissatisfaction with control, and/or deteriorating disease. Patient-reported outcomes included the Dermatology Life Quality Index (DLQI), Patient-Oriented Eczema Measure (POEM), and Work Productivity and Activity Impairment (WPAI-AD). RESULTS: Among 619 analyzed patients (mean age 40.5, 50% female), 30.2% had uncontrolled AD-36.4% treated with topicals-only and 63.6% with systemics ± topicals. Patients with uncontrolled AD on systemics reported higher symptom burden (DLQI 10.0, POEM 11.8) and activity impairment (WPAI 30.9) versus topicals-only (DLQI 3.3, POEM 8.7, WPAI 13.9). Absenteeism was notable in systemic-treated patients (12.1) but absent in topical-only groups. Patients with controlled AD showed lower symptom scores and better quality of life (QoL) across all treatments. Conventional systemics were associated with greater burden than advanced systemics. CONCLUSION: Despite available treatments, a substantial proportion of patients with moderate-to-severe AD remain uncontrolled, experiencing significant symptom burden and impaired QoL-underscoring the need for improved therapeutic strategies.